Highmark Health to slash physician reimbursement to contain ACA losses

Pittsburgh-based Highmark Health will cut reimbursement to physicians by 4 percent for care provided to patients with health insurance purchased on the Affordable Care Act exchange, according to the Pittsburgh Post-Gazette.

The pay cut will take effect April 1 for all Pennsylvania physicians who participate in Highmark's health insurance plans and treat patients with coverage bought on the ACA exchange.

The payment cut is necessary to trim losses in individual coverage, Alexis Miller, senior vice president of individual and small group markets at Highmark, told the Pittsburgh Post-Gazette.

Highmark lost $222 million on individual coverage offered on the ACA marketplace in 2014, and those losses widened to $318 million in the first six months of last year, according to the report.

Highmark's cutback plan is already facing criticism. John Krah, executive director of the Allegheny County Medical Society, told the Pittsburgh Post-Gazette physicians are being punished for Highmark's pricing miscalculations.

"Physicians will continue to provide the same level of care to these patients, but this is simply wrong," Mr. Krah said.

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